Sec. 19a-250. (Formerly Sec. 19-112a). Definitions. As used in this chapter,
"chronic illness" means conditions which require prolonged definitive hospital or restorative care as distinguished from diseases or conditions which may be properly cared for
in convalescent, custodial or domiciliary facilities, and "chronic disease hospital" means
a hospital operated by the Department of Public Health.

Sec. 19a-252. (Formerly Sec. 19-117). Administration of lung disease control
funds, including tuberculosis funds. The Department of Public Health is designated
as the state agency to administer and distribute state funds to be used for the control of
lung diseases, including tuberculosis, within the state. The director of health of any town
or of any district department of health or any nonprofit corporation may apply to said
department for funds to be used to assist in establishing, maintaining or expanding
services for treatment or control of lung diseases within the state.

History: 1959 act substituted for the commission on tuberculosis and other chronic illness, as agency to administer and
distribute funds, the state department of health through office of tuberculosis control, hospital care and rehabilitation; 1972
act replaced office of tuberculosis control, hospital care and rehabilitation with office of public health; P.A. 76-139 made
expenditures applicable to lung diseases generally and included expenditures for treatment; P.A. 77-614 replaced department of health with department of health services, effective January 1, 1979; Sec. 19-117 transferred to Sec. 19a-252 in
1983; P.A. 93-381 replaced department of health services with department of public health and addiction services, effective
July 1, 1993; P.A. 93-435 authorized substitution of "department" for "office", referring to office of public health, to carry
out purpose of P.A. 93-381 which deleted reference to office of public health appearing earlier in text, effective June 28,
1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner
and Department of Public Health, effective July 1, 1995.

Sec. 19a-253. (Formerly Sec. 19-119). Chronic disease hospitals: Admissions.
Except as provided in section 17a-502, on and after October 1, 2005, no patient shall
be admitted to a chronic disease hospital, unless the medical director of the hospital
determines that the hospital and its medical staff are capable of providing adequate care
and treatment to the patient, consistent with the hospital's by-laws. In making such
determination, the medical director shall have access to the patient's medical records
and may examine the patient.

History: 1972 act replaced office of tuberculosis control, hospital care and rehabilitation with office of public health;
P.A. 76-139 deleted redundant reference to admission to chronic disease hospitals, removed first preference for tuberculosis
patients and third preference for "other chronic cases in the order of application"; P.A. 77-614 replaced department of
health with department of health services, effective January 1, 1979; Sec. 19-119 transferred to Sec. 19a-253 in 1983; P.A.
93-381 replaced department of health services with department of public health and addiction services, effective July 1,
1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner
and Department of Public Health, effective July 1, 1995; P.A. 05-80 removed preferences for patients with chronic illnesses
and patients receiving public assistance, required medical director, rather than department, to determine the appropriateness
of admitting a patient to a chronic disease hospital and granted medical director access to patient medical records in order
to make such determination; P.A. 07-49 added exception re Sec. 17a-502.

(b) The Commissioner of Public Health may consider the availability of third-party
sources for the payment of any treatment rendered in accordance with subsection (a) of
this section when determining whether to pay for such services. If such patient is (1) a
veteran and the tuberculosis or suspected tuberculosis for which the veteran has been
hospitalized or treated is a service-connected disability entitling the veteran to medical
benefits, or (2) eligible for medical benefits under any workers' compensation law or
under any other private or public medical insurance or payment plan, such patient or
the patient's obligor shall be liable for the costs of such care to the extent of such available
benefits. Such costs shall be determined in the manner prescribed in subsection (a) of
section 17b-223.

(c) The Department of Social Services and the Department of Public Health may
exchange patient information in the possession of said departments for the purpose of
determining eligibility for benefits under Title XIX of the Social Security Act for any
patient in need of treatment or who has received treatment.

History: P.A. 76-139 made provisions applicable to tuberculosis cases in which medical care is required, allowed
admission to private hospitals or clinics having contract with the state and deleted reference to the "stage of the disease"; P.A.
82-46 authorized physicians and health care providers other than hospitals to care for tuberculosis patients and authorized the
state to pay only for that treatment which the commissioner of health services deemed appropriate; Sec. 19-121 transferred
to Sec. 19a-255 in 1983; P.A. 93-381 replaced commissioner of health services with commissioner of public health and
addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and
Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; (Revisor's note: In 1999
the references to "17b-115 to 17b-138" and "17b-689 to 17b-693, inclusive," were changed editorially by the Revisors to
"17b-116 to 17b-138" and "17b-689, 17b-689b" to reflect the repeal of certain sections by section 164 of June 18 Sp. Sess.
P.A. 97-2); June 30 Sp. Sess. P.A. 03-3, in repealing Secs. 17b-19, 17b-62, to 17b-65, inclusive, 17b-116, 17b-116a, 17b-116b, 17b-117, 17b-120, 17b-121, 17b-123, 17b-134, 17b-135, 17b-220, 17b-259 and 17b-287, authorized deletion of
internal references to said sections in this section, effective March 1, 2004; P.A. 04-76 deleted references to Secs. 17b-118b and 17b-221 that were repealed by the same act; Sept. Sp. Sess. P.A. 09-3 designated existing provisions as Subsec.
(a), amended same to delete reference to Sec. 17b-256 and delete provision re cost of care and treatment to be paid by the
state if cost is deemed appropriate by Commissioner of Public Health, added Subsec. (b) re Commissioner of Public Health
considering availability of third-party sources for payment of treatment and added Subsec. (c) re ability of Departments
of Public Health and Social Services to exchange patient information for purpose of determining patient eligibility for
Medicaid benefits, effective October 6, 2009.

Annotations to former section 19-121:

An action under this provision should not be entered on the jury docket. 15 CS 369. In action against executrix for
recovery of full cost of care, a mere billing and receipt of four dollars per week did not constitute a contract. 16 CS 118.

Sec. 19a-257. (Formerly Sec. 19-125). Support of patients with chronic illness
other than tuberculosis. Notwithstanding the provisions of sections 17b-222 and 17b-223, the maximum rate to be charged for the care of patients with chronic illness other
than tuberculosis in the state chronic disease hospitals shall be determined by the Commissioner of Administrative Services, in consultation with the Commissioner of Public
Health. The same persons and estates as are legally liable for support of patients in state
humane institutions shall be liable for support of patients with chronic illness other than
tuberculosis in said chronic disease hospitals in accordance with ability to pay and the
commissioner shall make the determination of such ability, shall bill for and shall collect
for care of such patients in the same manner and under the same procedures, terms and
conditions as are authorized under the laws governing cases of patients in state humane
institutions. If town paupers with chronic illnesses other than tuberculosis admitted to
said chronic disease hospitals are deemed by the Commissioner of Public Health not to
be in need of definitive hospital or restorative care, towns shall be liable for the support
of such paupers after two weeks' notice from said commissioner.

History: 1959 act substituted commissioner of health for commission on tuberculosis and other chronic illness and
clarified provision re town's liability for support of paupers; 1967 act deleted responsibility of welfare commissioner to
investigate financial circumstances of relatives, substituted health commissioner for welfare commissioner as authority
determining status of paupers and provided for finance commissioner rather than health commissioner to determine maximum rate chargeable for care; P.A. 77-614 replaced commissioner of finance and control with commissioner of administrative services and, effective January 1, 1979, replaced commissioner of health with commissioner of health services; Sec.
19-125 transferred to Sec. 19a-257 in 1983; P.A. 93-381 replaced commissioner of health services with commissioner of
public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public
Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995.

Annotations for former section 19-125:

Statute does not incorporate the limitation on liability provided for in Sec. 17-295. Designated commissioners are
authorized to set maximum rates for support of patients in chronic disease hospitals. 183 C. 330.

Sec. 19a-262. (Formerly Sec. 19-133). Report and record of cases. Each physician shall report in writing the name, age, sex, race, ethnicity, occupation, place where
last employed, if known, and address of each person under his care known or suspected
by such physician to have tuberculosis, to the Department of Public Health and the
director of health of the town, city or borough in which such person resides, within
twenty-four hours after the physician knows or suspects the presence of such disease,
and the officer in charge of any hospital, dispensary, asylum or other similar institution
shall report in like manner concerning each patient having tuberculosis who comes
under the care or observation of such officer, within twenty-four hours thereafter. The
Commissioner of Public Health and the director of health of each town, city or borough
shall keep a record of all such reports received by them, but such records shall not be
open to inspection by any person other than the health authorities of the state and of
such town, city or borough, and the identity of the person to whom any such report
relates shall not be divulged by such health authorities except as may be necessary to
carry into effect the provisions of this section, section 19a-263, and section 19a-264.
For purposes of this section and said sections a person may be suspected of having
tuberculosis if he has (1) an acid fast bacilli identified on a smear of his body fluids or
tissue, (2) been prescribed at least two antituberculosis drugs, (3) a preliminary diagnosis
which includes ruling out active tuberculosis or (4) signs or symptoms of active tuberculosis.

History: P.A. 76-139 removed reference to repealed Secs. 19-134 and 19-135; Sec. 19-133 transferred to Sec. 19a-262
in 1983; P.A. 90-13 replaced reference to "color" with references to race and ethnicity, applied provisions to persons
suspected of having tuberculosis and specified grounds for determining whether person is suspected of having tuberculosis
and required that physicians report to health services commissioner as well as to local director of health; P.A. 93-381
replaced department and commissioner of health services with department and commissioner of public health and addiction
services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction
Services with Commissioner and Department of Public Health, effective July 1, 1995.

Sec. 19a-263. (Formerly Sec. 19-136). Instruction by physicians to individuals.
The physician attending a patient having or suspected of having tuberculosis shall take
all necessary precautions and give adequate instructions to provide for the safety of all
individuals occupying the same house or apartments, and, if no physician is attending
such patient, such duties shall be performed by the local director of health.

Sec. 19a-264. (Formerly Sec. 19-137). Instructions by director of health to physicians. The local director of health shall transmit to any physician reporting a case
or suspected case of tuberculosis as provided in section 19a-262, a printed statement
describing such procedure and precautions as are deemed necessary or advisable to be
taken on the premises occupied by a tuberculosis patient, and such precautions shall be
communicated to the family of the patient. Any physician or person practicing as a
physician who wilfully makes any false statements in the reports provided for in said
section, and any person violating any of the provisions of said section, shall be fined
not less than five dollars nor more than fifty dollars or imprisoned not more than six
months or be both fined and imprisoned.

(1) "Active tuberculosis" means (A) a specimen has been taken from a pulmonary,
laryngeal or other airway source, has tested positive for tuberculosis and the person
tested has not subsequently completed a standard recommended course of medication
for tuberculosis, (B) a specimen from an extrapulmonary source has tested positive for
tuberculosis and there is clinical evidence or clinical suspicion of pulmonary tuberculosis and the person tested has not subsequently completed a standard recommended
course of medication for tuberculosis, or (C) where sputum smears or cultures are unobtainable, radiographic evidence, in addition to current clinical or laboratory evidence,
is sufficient to establish a medical diagnosis of pulmonary tuberculosis for which treatment is indicated and the person diagnosed has not subsequently completed a standard
recommended course of medication for tuberculosis.

(2) "Infectious tuberculosis" means tuberculosis disease in a communicable or infectious stage as determined by chest radiograph, the bacteriologic examination of body
tissues or secretions, or other diagnostic procedures. A person is considered infectious
to others until such time as sputum smears from a pulmonary, laryngeal or other airway
source collected on three consecutive days have tested negative for tuberculosis and the
person shows significant clinical improvement, such as the resolution of cough or fever.

(3) "Suspected of having active tuberculosis" means a person has signs or symptoms
of tuberculosis but diagnostic studies have not been completed.

(4) "Nonadherent" means not taking tuberculosis medications as prescribed or not
following the recommendations of the attending physician or health officer for the management of tuberculosis.

(5) "Enablers" means anything that helps the patient to more readily complete therapy including, but not limited to, assistance with transportation.

(6) "Incentive" means anything that motivates the patient to adhere to treatment
including, but not limited to, food or coupons.

(7) "Directly observed therapy" means a course of treatment for tuberculosis in
which the prescribed antituberculosis medication is administered to the person or ingested by the person under direct observation, as specified by the local director of health.

(b) The health care provider responsible for the treatment of any person with active
tuberculosis shall devise, with the assistance and acknowledgment of that person and
the approval of the director of health of the municipality in which the person with tuberculosis resides or, in the case of disagreement between the health care provider and the
director of health, the Commissioner of Public Health, an appropriate individualized
plan of treatment tailored to the person's medical and personal needs and identifying
the method for effective treatment and prevention of transmission. The director of health
shall provide or ensure the provision of such enablers and incentives as are within his
means to provide and are reasonably appropriate in the individual situation to help the
person to complete his course of treatment. In the event that the person with active
tuberculosis is hospitalized or in state custody, the director of health shall be notified
as required by section 19a-215, and the individualized plan of treatment shall be approved by the director prior to discharge, provided such discharge shall not be delayed
more than twenty-four hours, excluding weekends, solely because of delay in obtaining
this approval.

(c) If any town, city or borough director of health determines that the public health
is substantially and imminently endangered by a person with or suspected of having
active tuberculosis, he may take the following actions as reasonably necessary to protect
the public health: (1) Issue a warning stating that the person should have a physician's
examination for tuberculosis to a person who has active tuberculosis or who is suspected
of having active tuberculosis when that person is unable or unwilling voluntarily to
submit to such examination despite demonstrated efforts to educate and counsel the
person about the need for such examination; (2) issue a warning stating that the person
should complete an appropriate prescribed course of medication for tuberculosis when
that person has active tuberculosis but is unwilling or unable to adhere to an appropriate
prescribed course of medication despite a demonstrated effort to educate and counsel
the person about the need to complete the prescribed course of treatment and the offering
of such enablers and incentives as are reasonably appropriate to facilitate the completion
of treatment by that person; (3) issue a warning stating that the person should follow a
course of directly observed therapy for tuberculosis that should be given in such a manner
as shall minimize the time and financial burden on the person given that person's individual circumstances, when that person has active tuberculosis, has been nonadherent to
treatment for it and is unwilling or unable otherwise to adhere to an appropriate prescribed course of medication for tuberculosis despite a demonstrated effort to educate
and counsel the person about the need to complete the course of treatment and the
provision of such enablers and incentives to the person as are reasonably appropriate
to facilitate the completion of treatment by that person; (4) issue an emergency commitment order which shall extend for no more than ninety-six hours that authorizes the
removal to or detention in a hospital or other medically-appropriate setting of a person:
(A) Who has active tuberculosis that is infectious or who presents a substantial likelihood
of having active tuberculosis that is infectious based upon epidemiologic, clinical, radiographic evidence and laboratory test results; (B) who poses a substantial and imminent
likelihood of transmitting tuberculosis to others because of his or her inadequate separation from others, based on a physician's professional judgment using recognized infection control principles; (C) who is unwilling or unable to behave so as not to expose
others to risk of infection from tuberculosis despite a demonstrated effort to educate
and counsel the person about the need to avoid exposing others and required contagion
precautions; (D) who has expressed or demonstrated an unwillingness to adhere to the
prescribed course of treatment that would render the person noninfectious despite being
educated and counseled about the need to do so and being offered such enablers and
incentives as are reasonably appropriate to facilitate the completion of treatment; and
(E) for whom emergency commitment is the least restrictive alternative to protect the
public health. When issuing an emergency commitment order, the director of health
may direct a police officer or other designated transport personnel to immediately transport the person with tuberculosis as so ordered by the director of health. The police
officer shall take into custody and isolate the person in such a manner as required by
the director of health. The director of health shall notify the police officer or other
personnel concerning any necessary infection control procedures; (5) petition the Probate Court for a judicial commitment order that authorizes the removal to or detention
in a hospital or other medically-appropriate setting for the purposes of facilitating completion of a prescribed course of treatment for tuberculosis of a person: (A) Who has
active tuberculosis; (B) who is unwilling or unable to adhere to an appropriate prescribed
course of treatment for tuberculosis despite a demonstrated effort to educate and counsel
the person about the need to complete the course of treatment and to provide such
enablers and incentives to the person as are reasonably appropriate to facilitate the completion of treatment by that person; (C) who has demonstrated a pattern of persistent
nonadherence to treatment for tuberculosis; (D) for whom commitment for the purposes
of completion of the prescribed course of treatment for active tuberculosis is necessary
to prevent the development of drug-resistant tuberculosis organisms; and (E) for whom
commitment for the purpose of treatment for active tuberculosis is the least restrictive
course of action available to protect the public health in that other less restrictive alternatives to encourage that person's adherence to the prescribed course of treatment for
tuberculosis have failed.

(d) Any warning or order issued by the director under subdivisions (1) to (4), inclusive, of subsection (c) of this section, or a petition under subdivision (5) of subsection
(c) of this section, shall be in writing setting forth: (1) The name of the person who is
the subject of the warning, order or petition; (2) the factual basis for the director's
professional judgment that the person has active tuberculosis or, in the case of a warning
concerning examination, is suspected of having active tuberculosis; (3) in the case of a
warning concerning examination under subdivision (1) of subsection (c) of this section,
the efforts that have been made to educate and counsel the person about the need for
examination, the medical and legal consequences of failing to agree to it and the factual
basis for the director's professional judgment that the person is unable or unwilling
voluntarily to submit to such examination; (4) in the case of warnings and orders under
subdivisions (2) to (4), inclusive, of subsection (c) of this section and a petition under
subdivision (5) of subsection (c) of this section, the efforts that have been made to
educate and counsel the person about the need to complete the appropriate prescribed
course of treatment and the medical and legal consequences of failing to do so, a description of the enablers and incentives that have been offered or provided to the person, and
the factual basis for the director's professional judgment that the person is unable or
unwilling voluntarily to adhere to the appropriate prescribed course of treatment; (5) in
the case of an emergency commitment order under subsection (c) of this section, the
factual basis for the director's professional judgment that: (A) The person is infectious
or presents a substantial likelihood of being infectious; (B) the person poses a substantial
and imminent likelihood of transmitting tuberculosis to others; (C) the person is unable
or unwilling to behave so as not to expose others to risk of infection; and (D) emergency
commitment is the least restrictive alternative available to protect the public health; (6)
in the case of a petition for commitment under subsection (c) of this section, the factual
basis for the director's professional judgment that: (A) The person has been persistently
nonadherent to treatment for tuberculosis; (B) commitment for the purpose of treatment
for active tuberculosis is necessary to prevent the development of drug-resistant tuberculosis organisms; (C) commitment for the purpose of treatment for active tuberculosis
is the least restrictive alternative to protect the public health in that other alternatives
to encourage that person's adherence to treatment have failed. Any warnings or orders
issued pursuant to subsections (c) and (k) of this section shall specify the period of time
that the warning or order is to remain effective, provided: (i) Any order authorizing
examination for tuberculosis shall not continue beyond the minimum period of time
required, with the exercise of all due diligence, to make a medical determination of
whether the person who has active tuberculosis is infectious or whether the person who
is suspected of having tuberculosis has active tuberculosis; (ii) any warning concerning
treatment or directly observed therapy shall not continue beyond the conclusion of the
prescribed course of antituberculosis treatment; and (iii) any order authorizing emergency commitment shall not exceed ninety-six hours. Any order for emergency commitment or petition for commitment shall specify the place of confinement, which shall be
in a facility approved by the Commissioner of Public Health and which shall not be a
prison, jail or other enclosure where those charged with a crime are incarcerated unless
the person who is the subject of the order is being held on a criminal charge. Within
twenty-four hours of the issuance of the order or petition, the director of health shall
notify the Commissioner of Public Health that such an order or petition has been issued.

(e) The director of health may make application to the probate court for the district
in which a person subject to a warning issued under subdivision (1) of subsection (c)
of this section resides for an enforcement order. A person concerning whom said application is made shall have the right to a court hearing which shall be held by the probate
court within three business days of receipt of such application. The hearing shall be held
to determine: (1) If the person has active tuberculosis or is suspected of having active
tuberculosis; (2) if the person is unable or unwilling to be examined voluntarily; (3) if
efforts have been made to educate the person about the need for examination; (4) whether
the order is necessary and is the least restrictive alternative to protect the public health.
The Probate Court may issue a warrant for the apprehension of a person who is the
subject of an order for examination, and a police officer for the town in which such
court is located, or if there is no such police officer then the state police or such other
officer as the court may determine, shall deliver the person to a facility for examination
as directed by the health director.

(f) Immediately upon issuance of an emergency commitment order under subdivision (4) of subsection (c) of this section, the director of health shall petition the probate
court for the district in which the person who is subject to the order resides to determine
whether such commitment shall be continued. The petition shall be heard by the judge
of probate for such district, except that on motion of the respondent or the judge of
probate for appointment of a three-judge court, the Probate Court Administrator shall
appoint a three-judge court from among the several judges of probate to conduct the
hearing. Such three-judge court shall consist of at least one judge who is an attorney-at-law admitted to practice in this state. The judge of probate having jurisdiction under
the provisions of this section shall be a member, provided such judge may disqualify
himself or herself, in which case all three members of such court shall be appointed by
the Probate Court Administrator. Such three-judge court when convened shall be subject
to all of the provisions of law as if it were a single-judge court. The involuntary confinement of a person under this section by a three-judge court shall not be ordered by the
court without the vote of at least two of the three judges convened hereunder. The judges
of such court shall designate a chief judge from among their members. All records for
any case before the three-judge court shall be maintained by the court of probate having
jurisdiction over the matter as if the three-judge court had not been appointed. The
hearing, whether before a one-judge or three-judge court, shall be held within ninety-six hours, excluding Saturdays, Sundays and legal holidays, of the issuance of such
order of emergency commitment and the court shall cause such advanced notice as it
directs thereof to be given to the person who is the subject of the order and such other
persons as it may direct. The court shall determine: (1) If the person has active tuberculosis that is infectious or presents a substantial likelihood of having active tuberculosis
that is infectious based upon epidemiologic, clinical, or radiographic evidence, and
laboratory test results; (2) if the person poses a substantial and imminent likelihood of
transmitting tuberculosis to others because of inadequate separation from others, based
on a physician's professional judgment using recognized infection control principles;
(3) if the person is unwilling or unable to behave so as to not expose others to risk of
infection from tuberculosis; (4) if efforts have been made to educate and counsel the
person about the need to avoid exposing others and required contagion precautions; (5)
if the person has expressed or demonstrated an unwillingness to adhere to the prescribed
course of treatment that would render the person noninfectious; (6) if efforts have been
made to educate and counsel about the need to complete treatment and if reasonably
appropriate enablers and incentives have been offered to facilitate the completion of
treatment; and (7) whether the order is necessary and is the least restrictive alternative
to protect the public health.

(g) A petition by a director of health for a commitment order pursuant to subdivision
(5) of subsection (c) of this section shall be heard by the probate court for the district
in which the subject of such petition resides within three business days of receipt of
such petition or, if a motion is made for appointment of a three-judge court, within three
business days of the filing of such motion. Upon the motion of the respondent or of the
judge of probate for appointment of a three-judge court, the Probate Court Administrator
shall appoint a three-judge court from among the several judges of probate to conduct
the hearing. Such three-judge court shall consist of at least one judge who is an attorney-at-law admitted to practice in this state. The judge of probate having jurisdiction under
the provisions of this section shall be a member, provided such judge may disqualify
himself, in which case all three members of such court shall be appointed by the Probate
Court Administrator. Such three-judge court when convened shall be subject to all of
the provisions of law as if it were a single-judge court. The involuntary confinement of
a person under this section by a three-judge court shall not be ordered by the court
without the vote of at least two of the three judges convened hereunder. The judges of
such court shall designate a chief judge from among their members. All records for any
case before the three-judge court shall be maintained by the court of probate having
jurisdiction over the matter as if the three-judge court had not been appointed. The court
shall cause such advanced notice as it directs thereof to be given to the person who is
the subject of the order and such other persons as it may direct. The hearing shall be
held to determine: (1) If the person has active tuberculosis; (2) if the person is unwilling
or unable to adhere to an appropriate prescribed course of treatment for tuberculosis;
(3) if efforts have been made to educate and counsel the person about the need to complete the course of treatment; (4) if reasonably appropriate enablers and incentives have
been provided to the person to facilitate the completion of treatment by that person; (5)
if the person has a demonstrated pattern of persistent nonadherence to treatment for
tuberculosis; (6) if commitment for the purposes of completion of the prescribed course
of treatment for active tuberculosis is necessary to prevent the development of drug-resistant tuberculosis organisms; and (7) whether the order is necessary and is the least
restrictive available to protect the public health in that other less restrictive alternatives to
encourage that person's adherence to the prescribed course of treatment for tuberculosis
have failed. The Probate Court may issue a warrant for the apprehension of a person
who is the subject of an order for commitment, and a police officer for the town in which
such court is located, or if there is no such police officer then the state police or such other
officer as the court may determine, shall deliver the person to the place for confinement as
determined by the health director and as specified in subsection (d) of this section.

(h) All orders by health directors and all applications or petitions for a hearing under
this section shall be hand-delivered to the person subject to the order as quickly as
reasonably possible and shall inform him that: (1) He or his representative has a right
to be present at the hearing; (2) he has a right to counsel and, if indigent or otherwise
unable to pay for or to obtain counsel, he has a right to have counsel appointed to
represent him; (3) the court shall have the right to appoint and hear additional expert
witnesses at the expense of the petitioner; (4) he has a right to be present and to cross-examine witnesses testifying at the hearing; (5) the proceedings before the Probate Court
shall be recorded and shall be transcribed if he appeals or files a writ of habeas corpus;
(6) the proceedings before the court shall be confidential and shall not be disclosed
unless he or his legal representative requests, or the Probate Court so orders for good
cause shown; (7) he has a right to appeal an order of the Probate Court to the Superior
Court; and (8) he has a right to apply to the Probate Court to terminate or modify an
order it has made under subsection (k) of this section, as provided in subsection (l) of
this section. If the court finds that such person is indigent or otherwise unable to pay
for or to obtain counsel, the court shall appoint counsel for him, unless such person
refuses counsel and the court finds that the person understands the nature of his refusal.
If the person does not select his own counsel, or if counsel selected by the person refuses
to represent him or is not available for such representation, the court shall appoint counsel
for the person from a panel of attorneys admitted to practice in this state provided by
the Probate Court Administrator in accordance with regulations promulgated by the
Probate Court Administrator in accordance with section 45a-77. The reasonable compensation of appointed counsel for a person who is indigent or otherwise unable to pay
for counsel shall be established by, and paid from funds appropriated to, the Judicial
Department, however, if funds have not been included in the budget of the Judicial
Department for such purposes, such compensation shall be established by the Probate
Court Administrator and paid from the Probate Court Administration Fund.

(i) Prior to any hearing under this section, such person or his counsel shall be afforded access to all the person's medical records including, without limitation, hospital
records if such person is hospitalized. If such person is hospitalized at the time of the
hearing the hospital shall provide the person or his counsel access to all records in its
possession relating to the condition of the person. Nothing in this subsection shall prevent timely objection to the admissibility of evidence in accordance with the rules of
civil procedure.

(j) At any hearing held under this section, the director of health shall have the burden
of showing by clear and convincing evidence that: (1) The person has active tuberculosis
or, in the case of an examination order, is suspected of having active tuberculosis; (2)
in the case of an enforcement order for examination, that efforts have been made to
educate and counsel the person about the need for examination and that the person
remains unable or unwilling voluntarily to submit to such examination; (3) in the case
of an order under subdivision (4) of subsection (c) of this section and a petition under
subdivision (5) of said subsection (c), that efforts that have been made to educate and
counsel that person about the need to complete the appropriate prescribed course of
treatment and that reasonably appropriate enablers and incentives have been offered or
provided to the person, and that the person remains unable or unwilling voluntarily to
adhere to the appropriate prescribed course of treatment; (4) in the case of continuation
of an emergency commitment order under subdivision (4) of subsection (c) of this section
that: (A) The person is infectious or presents a substantial likelihood of being infectious,
(B) the person poses a substantial and imminent likelihood of transmitting tuberculosis
to others, (C) the person is unable or unwilling to behave so as not to expose others to
risk of infection and (D) commitment is the least restrictive alternative available to
protect the public health; (5) in the case of a petition for commitment under subdivision
(5) of subsection (c) of this section, that (A) the person has been persistently nonadherent
to treatment for tuberculosis, (B) commitment for the purpose of treatment for active
tuberculosis is necessary to prevent the development of drug-resistant tuberculosis
organisms, (C) commitment for the purpose of treatment for active tuberculosis is the
least restrictive alternative to protect the public health in that other alternatives to encourage said person's adherence to treatment have failed; and (6) the order sought by the
director of health is necessary and is the least restrictive alternative to protect the public
health.

(k) If the court, at such hearing, finds by clear and convincing evidence that the
director of health has met the burden of proof set forth in subsection (j) of this section,
the court shall: (1) In the case of examination orders: (A) Order such person to be
examined; or (B) enter an order with such terms and conditions as the court deems
appropriate to protect the public health in the manner least restrictive of the individual's
liberty and privacy; (2) in the case of a continuation of an emergency commitment
issued pursuant to subdivision (4) of subsection (c) of this section, (A) enter an order,
authorizing the continued commitment of such person only for as long as the person
remains infectious and poses a risk of transmission to others, or (B) enter an order with
such terms and conditions as the court deems appropriate to protect the public health
in the manner least restrictive of the individual's liberty and privacy; and (3) in the case
of a petition for a commitment order for treatment issued pursuant to subdivision (5) of
subsection (c) of this section, (A) order the continued commitment, but only for as
long as is necessary to complete the prescribed course of treatment or to demonstrate
adherence to treatment, or (B) enter an order with such terms and conditions as the court
deems appropriate to protect the public health in the manner least restrictive of the
individual's liberty and privacy. If the court, at such hearing, finds that the director of
health has failed to meet such burden of proof, the court shall enter no orders, provided,
if the person has been subject to an emergency commitment, the court shall order a
release from such commitment.

(l) Such person may, at any time, move the court to terminate or modify an order
made under subsection (k) of this section, in which case a hearing shall be held within
five business days in accordance with this subsection. In addition, the court shall, on
its own motion, review at least every six months any order of commitment issued under
this section to determine if the conditions that required the commitment or restriction
of the person still exist. If the court finds at such hearing, held on motion of the person
or on its own motion, that the conditions that warranted the issuance of the order no
longer exist, it shall dissolve said order. At such hearing, the director of health shall
bear the burden of proof as specified in subsection (j) of this section.

(m) Any person aggrieved by an order of the Court of Probate under this section
may take an appeal to the Superior Court. The Probate Court shall cause a recording of
any hearing held pursuant to this section to be made, to be transcribed only in the event
of an application for a writ of habeas corpus or an appeal from the decree rendered
hereunder. A copy of such transcript shall be furnished without charge to the appellant
or applicant for the writ of habeas corpus whom the Court of Probate finds unable to
pay for the same. In such case, the cost of preparing such transcript shall be paid by the
original petitioner.

(n) The provisions of this section shall not be construed to permit or require the
forcible administration of any medication.

(o) All health directors' orders, applications or petitions for a hearing, notices of a
hearing and proceedings of a hearing under this section shall be kept confidential and
shall not be disclosed, except to the parties to the proceeding, or upon the request of the
person who is the subject of the order or his legal representative, or upon order of the
Probate Court for good cause shown.

(p) All health directors' emergency commitment orders and warnings shall be in a
language that the person who is the subject of the warning or order can comprehend.

(q) The commissioner may adopt, in accordance with chapter 54, such regulations
as are necessary to carry out and enforce the provisions of subsection (b) of this section.

History: P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 96-170 amended Subsec. (h) by changing funding of
compensation of counsel from Probate Court Administration Fund to funds appropriated to Judicial Department, unless
funds not included in budget of Judicial Department for such purpose, effective July 1, 1998; P.A. 97-90 amended Subsec.
(f) by adding provision excluding Saturdays, Sundays and legal holidays from hearing required to be held within 96 hours,
and revised effective date of P.A. 96-170 but without affecting this section, effective July 1, 1997; P.A. 98-52 amended
Subsec. (g) by adding provision re motion for appointment of three-judge panel; P.A. 99-84 amended Subsec. (f) by adding
provision that petition shall be heard by judge of probate for district, unless there is motion of respondent or judge of
probate for a three-judge panel; P.A. 06-196 made technical changes in Subsec. (k), effective June 7, 2006.

(3) "Unserved or underserved populations" means women who are: (A) At or below
two hundred per cent of the federal poverty level for individuals; (B) without health
insurance that covers breast cancer screening mammography or cervical cancer screening services; and (C) nineteen to sixty-four years of age.

(b) There is established, within existing appropriations, a breast and cervical cancer
early detection and treatment referral program, within the Department of Public Health,
to (1) promote screening, detection and treatment of breast cancer and cervical cancer
among unserved or underserved populations, (2) educate the public regarding breast
cancer and cervical cancer and the benefits of early detection, and (3) provide counseling
and referral services for treatment.

(c) The program shall include, but not be limited to:

(1) Establishment of a public education and outreach initiative to publicize breast
cancer and cervical cancer early detection services and the extent of coverage for such
services by health insurance; the benefits of early detection of breast cancer and the
recommended frequency of screening services, including clinical breast examinations
and mammography; and the medical assistance program and other public and private
programs and the benefits of early detection of cervical cancer and the recommended
frequency of pap tests;

(2) Development of professional education programs, including the benefits of early
detection of breast cancer and the recommended frequency of mammography and the
benefits of early detection of cervical cancer and the recommended frequency of pap
tests;

(3) Establishment of a system to track and follow up on all women screened for
breast cancer and cervical cancer in the program. The system shall include, but not be
limited to, follow-up of abnormal screening tests and referral to treatment when needed
and tracking women to be screened at recommended screening intervals;

(4) Assurance that all participating providers of breast cancer and cervical cancer
screening are in compliance with national and state quality assurance legislative mandates.

(d) The Department of Public Health shall provide unserved or underserved populations, within existing appropriations and through contracts with health care providers:
(1) Clinical breast examinations, screening mammograms and pap tests, as recommended in the most current breast and cervical cancer screening guidelines established
by the United States Preventive Services Task Force, for the woman's age and medical
history; (2) a sixty-day follow-up pap test for victims of sexual assault; and (3) a pap
test every six months for women who have tested HIV positive.

(e) The Commissioner of Public Health shall report annually to the joint standing
committees of the General Assembly having cognizance of matters relating to public
health and appropriations. The report shall include, but not be limited to, a description
of the rate of breast cancer and cervical cancer morbidity and mortality in this state and
the extent of participation in breast cancer and cervical cancer screening.

(f) The organizations providing the testing and treatment services shall report to
the Department of Public Health the names of the insurer of each underinsured woman
being tested to facilitate recoupment.

History: P.A. 96-238 effective July 1, 1996; June 18 Sp. Sess. P.A. 97-8 changed 40 to 19 years of age in Subsec. (a)(3),
changed 2 years to 1 year and changed under age 50 to age 45 to 64 in Subsec. (d)(1), changed over the age of 50 to age
35 to 40 with a first degree relative or other risk factor in Subsec. (d)(2), limited test to those age 19 to 64 who have had
a positive finding, otherwise every 3 years or as directed by physician in Subsec. (d)(3) and added Subsecs. (d)(4) re follow
up tests and (d)(5) re tests if HIV positive, in Subsec. (f) added appropriations committee and added new Subsec. (g) re
names of insurers, effective July 1, 1997; P.A. 98-36 made a technical correction in Subsec. (f), changing "committee" to
"committees"; P.A. 00-216 amended Subsec. (e) by adding provisions re use of settlement payments for breast and cervical
cancer treatment services, effective July 1, 2000; P.A. 06-195 amended Subsec. (a) by substituting "breast cancer screening
and referral services" for "breast cancer treatment services" in Subdiv. (1) and redefining such services, and by substituting
"cervical cancer screening and referral services" for "cervical cancer treatment services" in Subdiv. (2) and redefining
such services, amended Subsec. (b) by adding Subdiv. designators (1) to (3), inclusive, and making technical changes,
amended Subsec. (c) by adding provision in Subdiv. (1) expanding program content to include benefits of early detection
and recommended frequency of screening services, including clinical breast exams and mammography, by making technical
changes in Subdiv. (3), and by substituting "assurance" for "insurance" in Subdiv. (4), amended Subsec. (d) by deleting
former Subdivs. (1) to (4), inclusive, adding new Subdiv. (1) re breast exams, screening mammograms and pap tests for
unserved and underserved populations and renumbering existing Subdivs. (4) and (5) as Subdivs. (2) and (3), respectively,
deleted former Subsec. (e) re application for and receipt of money from public and private sources for early detection and
treatment referral, and redesignated existing Subsecs. (f) and (g) as Subsecs. (e) and (f), respectively, effective June 7, 2006.

See Sec. 17b-278b re authority of Commissioner of Social Services to seek federal waivers or amend Medicaid plan
so as to secure federal reimbursement for costs of program.

Sec. 19a-266a. Gynecologic cancers information pamphlet. The Department of
Public Health shall develop a pamphlet containing summary information concerning
gynecologic cancers, including cervical, ovarian and uterine cancer. Such pamphlet
shall contain standardized information with respect to such cancers, written in plain
language, that includes (1) signs and symptoms, (2) risk factors, (3) the benefits of early
detection through appropriate diagnostic testing, (4) treatment options, and (5) such
other information as the department deems necessary. The department shall make such
pamphlet available to hospitals, physicians and other health care providers for distribution to patients. The department shall also prepare appropriate multilingual versions of
such pamphlet for use by Spanish-speaking and other non-English-speaking patients.